Organization Active NPI

Vip Eye Care and Eye Wear Inc

  • Optometrist
  • Saint Petersburg, FL
National Provider Identifier
1336575554
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC0002526 Issued in FL
Legal business name
VIP EYE CARE AND EYE WEAR INC
Practice address
2201 4TH St N Ste a
Saint Petersburg, FL 33704-4300
Phone
(727) 894-0500
Fax
(727) 823-8697
NPI assigned
Sep 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mona A Henri, O.D.NPI 1003818915
Title
Owner
Phone
(727) 894-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPC0002526 FL Primary

Addresses

Primary practice location

2201 4TH St N Ste a
Saint Petersburg, FL 33704-4300

Mailing address

2201 4TH St N Ste a
Saint Petersburg, FL 33704-4300
Phone (727) 894-0500

Other identifiers 1

IdentifierTypeStateIssuer
078852000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131107001435 FL Part B Supplier - Clinic/Group Practice 3173758679 Receives reassigned benefits from 3 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

2201 4th St N
Ste A
St Petersburg, FL 33704
Phone (727) 894-0500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1336575554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 4TH ST N STE A",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337044300",
            "telephone_number": "727-894-0500",
            "fax_number": "727-823-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 4TH ST N STE A",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337044300",
            "telephone_number": "727-894-0500",
            "fax_number": "727-823-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP EYE CARE AND EYE WEAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-19",
        "last_updated": "2024-01-31",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "HENRI",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-894-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC0002526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078852000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.